<div id="mid">
    <div id="leftcol">
        <div id="text">
            <p style="font-family:Garamond; font-size:30px"><i>&quot;We give proactive altruisic advice which leadership team can use to translate into remarkable results&quot;</i></p>
        </div>

    </div>
    <div id="rigtcol">
        <h2>Please Register and take a PACEM Survey</h2>
        <form id="register">
            <div class="label-input">Company Name:</div>
            <div style="float:left"><input type="text" /></div><br/><br/><br/>

            <div class="label-input">Full Name:</div>
            <div style="float:left"><input type="text" /></div><br/><br/><br/>

            <div class="label-input">Position:</div>
            <div style="float:left"><input type="text" /></div><br/><br/><br/>

            <div class="label-input">Email:</div>
            <div style="float:left"><input type="text" /></div><br/><br/><br/>

            <div class="label-input"></div>
            <div style="float:left; font-family:Wide Latin;"><input type="submit" id="submit"  value="Click for PACEM"/></div><br/><br/><br/>
        </form></div>
</div>

<script type="text/javascript">
    $(document).ready(function(){
        $("#register-form").validationEngine();
    });
</script>